Provider Demographics
NPI:1003016882
Name:CUMBERLAND FAMILY MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:CUMBERLAND FAMILY MEDICAL CENTER, INC.
Other - Org Name:ADAIR FAMILY MEDICAL CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF BUSINESS ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:
Authorized Official - Last Name:HAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-864-1472
Mailing Address - Street 1:PO BOX 1080
Mailing Address - Street 2:
Mailing Address - City:BURKESVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42717-1080
Mailing Address - Country:US
Mailing Address - Phone:270-864-1472
Mailing Address - Fax:270-864-1693
Practice Address - Street 1:937 CAMPBELLSVILLE RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:KY
Practice Address - Zip Code:42728-2265
Practice Address - Country:US
Practice Address - Phone:270-384-2777
Practice Address - Fax:270-384-2770
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CUMBERLAND FAMILY MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-20
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100017280Medicaid
KY7100017280Medicaid